Partial nephrectomy vs. radical nephrectomy for stage I renal cell carcinoma in the presence of predisposing systemic diseases for chronic kidney disease
| Autor: | Ugur Mungan, Kaan Çömez, Omer Demir, Serdar Çelik, Ilhan Celebi, Ahmet Adil Esen, Ozan Bozkurt, Güven Aslan |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Stage I Renal Cell Carcinoma Patient demographics medicine.medical_treatment 030232 urology & nephrology Urology Renal function Disease Kidney urologic and male genital diseases Nephrectomy 03 medical and health sciences 0302 clinical medicine Chronic kidney disease Diabetes mellitus eGFR medicine Partial nephrectomy Humans In patient Postoperative Period Renal Insufficiency Chronic Carcinoma Renal Cell Aged lcsh:R5-920 business.industry Renal functions General Medicine Middle Aged medicine.disease Kidney Neoplasms Surgery Kidney tumors 030220 oncology & carcinogenesis Hypertension Female lcsh:Medicine (General) business Glomerular Filtration Rate Kidney disease |
| Zdroj: | Kaohsiung Journal of Medical Sciences, Vol 33, Iss 7, Pp 339-343 (2017) |
| ISSN: | 1607-551X |
| Popis: | Aim of this study is to compare the effects of partial nephrectomy (PN) and radical nephrectomy (RN) for stage I renal cell carcinoma (RCC) on renal functions in patients with diabetes mellitus (DM) and/or hypertension (HT). Charts of patients who underwent surgery for stage I RCC in our department were retrospectively reviewed and patients with DM and/or HT were enrolled. Preoperative and postoperative estimated glomerular filtration rates (eGFR) were calculated according to the Modification of Diet in Renal Disease (MDRD) formulation for both RN and PN groups. Groups were compared for patient demographics, preoperative eGFR, postoperative eGFR and Delta eGFR [(preoperative eGFR) - (postoperative eGFR)] which reflects the renal functional loss. There were 85 patients in the RN and 33 patients in the PN groups. Demographic data were similar but the patients in the PN group had smaller tumor size compared to RN group (32.2 +/- 11.8 mm vs 47.1 +/- 15.2 mm, p < 0.001). Preoperative eGFR did not differ between groups (75 +/- 28.4 mL/min/1.73 m(2) vs 75.5 +/- 23.8 mL/min/1.73 m(2) in RN and PN groups, p = 0.929). However, there were significant differences between groups in terms of postoperative eGFR (57.5 +/- 21.7 mL/min/1.73 m(2) vs 74 +/- 27.5 mL/min/1.73 m(2) in RN and PN groups, p < 0.001) and DeGFR (17.5 +/- 4.2 mL/min/1.73 m(2) vs 1.5 +/- 0.4 mL/min/1.73 m(2) in RN and PN groups, p < 0.001). Our findings favor the use of PN over RN for stage I RCC whenever feasible in patients with predisposing systemic diseases for chronic kidney disease for better preservation of renal functions. Copyright (C) 2017, Kaohsiung Medical University. Published by Elsevier Taiwan LLC. |
| Databáze: | OpenAIRE |
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